Optimal visualization is vital to retinal surgery outcome.
The retinal endoscope can bypass anterior segment opacities, and enhance visualization of anterior structures, otherwise not visible through a standard operating microscope.
The endoscope is particularly helpful when corneal opacification, hyphema, or other processes cloud the view.
Using small gauge endoscopy can aid in the treatment of glaucoma, retinal detachments, open globe injuries, intraocular foreign bodies, and severe endophthalmitis.
Affords a wide-angle high-resolution view.
Smaller gauges have the advantage of smaller incisions.
The current state of endoscopy technology in ophthalmology is represented by the E2 Laser and endoscopy system that incorporates illumination, and laser capability in endoscopy probes as thin as 0.57 mm (23 gauge).
The laser output and pulse width, the aiming beam intensity, and the light source can be controlled from a touch pad or a footpedal.
The diode laser operates in the near infrared at 810 nm, and the xenon light source can be either 175 or 300 W.
Devices includes a high-resolution camera and is autoclavable.
A gradient index lens system that offers higher resolution but a narrower field of view is available.
Retinal endoscopy can provide benefits in vitreous surgery that cannot be obtained with a conventional operating microscope view.
It allows visualization independent of poor media, with the capability to provide variable perspective and high magnification.
Allows the ability to see posterior segment structures such as corneal or anterior segment scarring, hemorrhage, or lenticular opacity.
The flexibility of the endoscopic probe allows changes in perspective as vitrectomy surgery progresses, with field of view varying from 90° to 140°.
The wider fields it allows make it more efficacious and safe, and its high magnification, especially facilitates identification of small retinal breaks.
Indications for which endoscopy-assisted vitrectomy include ischemic retinopathies, such as proliferative diabetic retinopathy and central retinal vein occlusion, as well as uncontrolled glaucoma and neovascular glaucoma.
Can assist following cataract surgery, in recovering subluxated nucleus material or a dropped intraocular lens (IOL).
Can help in managing severe endophthalmitis, peeling of epiretinal and internal limiting membranes, injection of dyes for visualization, and the high magnification can aid in the identification of membrane borders for peeling.
The most common use of endoscopy in ophthalmology has been for endoscopic cyclophotocoagulation (ECP) in patients with glaucoma.
Provides excellent visualization in eyes with compromised view through the cornea, anterior segment, or lens.